Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China

Hand, Foot, and Mouth Disease (HFMD) is a prevalent childhood infectious disease caused by enteroviruses, posing significant public health concerns in China. This study aimed to provide information and evidence to guide public health response and intervention by exploring the trends of HFMD incidenc...

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Main Authors: Fei Zhao, Canya Fu, Wenjie Xu, Canjie Zheng, Xiaoying Gong, Quanjun Fang, Chuanxi Fu, Zhiying Yin
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Critical Public Health
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Online Access:https://www.tandfonline.com/doi/10.1080/09581596.2025.2503280
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author Fei Zhao
Canya Fu
Wenjie Xu
Canjie Zheng
Xiaoying Gong
Quanjun Fang
Chuanxi Fu
Zhiying Yin
author_facet Fei Zhao
Canya Fu
Wenjie Xu
Canjie Zheng
Xiaoying Gong
Quanjun Fang
Chuanxi Fu
Zhiying Yin
author_sort Fei Zhao
collection DOAJ
description Hand, Foot, and Mouth Disease (HFMD) is a prevalent childhood infectious disease caused by enteroviruses, posing significant public health concerns in China. This study aimed to provide information and evidence to guide public health response and intervention by exploring the trends of HFMD incidence among children under 10 years old in Quzhou from 2009 to 2023, and analyzing the influence of age, period, and cohort. Data on HFMD cases in Quzhou from 2009 to 2023 were collected and then analyzed using Joinpoint regression and age-period-cohort (APC) model to explore incidence trends and potential causes. A total of 75,284 HFMD cases were reported in Quzhou from 2009 to 2023, with children under 10 years old accounting for 99.01% of the cases. The main age group for onset was centered between 1 and 3 years. Before 2017, EV71 was the main pathogen in 3,360 laboratory-confirmed HFMD cases, followed by Cox A16. Since 2018, Cox A16 and Cox A6 have dominated. Serious cases have declined significantly since 2016. Joinpoint regression analysis showed two inflection points (2013 and 2021) with an up-down-up trend. The APC model indicated concentrated risk in children aged 1–3 years, with a periodic fluctuating trend of period effect and an overall increasing trend of cohort effect. The use of EV71 vaccine has temporarily reduced HFMD incidence, but the changing pathogen spectrum has led to a resurgence, highlighting the need to expedite the development and use of vaccines against Cox A strains to mitigate the impact of this disease.
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spelling doaj-art-76ffc9a2c09e4459bf941f86a96485262025-08-20T03:09:19ZengTaylor & Francis GroupCritical Public Health0958-15961469-36822025-12-0135110.1080/09581596.2025.2503280Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, ChinaFei Zhao0Canya Fu1Wenjie Xu2Canjie Zheng3Xiaoying Gong4Quanjun Fang5Chuanxi Fu6Zhiying Yin7Department of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaDepartment of Epidemiology, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Immunity, Quzhou Center for Disease Control and Prevention, Quzhou, ChinaHand, Foot, and Mouth Disease (HFMD) is a prevalent childhood infectious disease caused by enteroviruses, posing significant public health concerns in China. This study aimed to provide information and evidence to guide public health response and intervention by exploring the trends of HFMD incidence among children under 10 years old in Quzhou from 2009 to 2023, and analyzing the influence of age, period, and cohort. Data on HFMD cases in Quzhou from 2009 to 2023 were collected and then analyzed using Joinpoint regression and age-period-cohort (APC) model to explore incidence trends and potential causes. A total of 75,284 HFMD cases were reported in Quzhou from 2009 to 2023, with children under 10 years old accounting for 99.01% of the cases. The main age group for onset was centered between 1 and 3 years. Before 2017, EV71 was the main pathogen in 3,360 laboratory-confirmed HFMD cases, followed by Cox A16. Since 2018, Cox A16 and Cox A6 have dominated. Serious cases have declined significantly since 2016. Joinpoint regression analysis showed two inflection points (2013 and 2021) with an up-down-up trend. The APC model indicated concentrated risk in children aged 1–3 years, with a periodic fluctuating trend of period effect and an overall increasing trend of cohort effect. The use of EV71 vaccine has temporarily reduced HFMD incidence, but the changing pathogen spectrum has led to a resurgence, highlighting the need to expedite the development and use of vaccines against Cox A strains to mitigate the impact of this disease.https://www.tandfonline.com/doi/10.1080/09581596.2025.2503280Hand, foot, and mouth diseasetrend analysisJoinpoint regression modelage–period–cohort model
spellingShingle Fei Zhao
Canya Fu
Wenjie Xu
Canjie Zheng
Xiaoying Gong
Quanjun Fang
Chuanxi Fu
Zhiying Yin
Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
Critical Public Health
Hand, foot, and mouth disease
trend analysis
Joinpoint regression model
age–period–cohort model
title Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
title_full Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
title_fullStr Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
title_full_unstemmed Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
title_short Trends and age-period-cohort effects on the incidence of hand, foot, and mouth disease among children younger than 10 years old from 2009 to 2023 in Quzhou, China
title_sort trends and age period cohort effects on the incidence of hand foot and mouth disease among children younger than 10 years old from 2009 to 2023 in quzhou china
topic Hand, foot, and mouth disease
trend analysis
Joinpoint regression model
age–period–cohort model
url https://www.tandfonline.com/doi/10.1080/09581596.2025.2503280
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